LVADS

[fireflymedic]

Went to Oak Lawn, Illinois.

We got to play with the various models- learned how they work, how to change batteries, etc. Hands on stations with the company reps as well as the LVAD coordinators. Since they are on call 24/7 and very anxious for us to utilize them. I actually have their phone numbers programmed in my personal cell phone. If I know we are going to an LVAD patient, I will be on the phone with them before we even arrive on the scene.

Christ? Well Advocate I guess it is now? I'm not there now, but used to live up that direction. Didn't know if they were a big heart place or what. They had just built the pedi hospital when I left. Anyhow - we got similar education and contacts as you did, and yep, I did the same thing - those numbers are easily accessible !

[HERBIE1]

Christ? Well Advocate I guess it is now? I'm not there now, but used to live up that direction. Didn't know if they were a big heart place or what. They had just built the pedi hospital when I left. Anyhow - we got similar education and contacts as you did, and yep, I did the same thing - those numbers are easily accessible !

Yep.

It's one of several places in the area that utilize the devices.

Apparently East Coast EMS is more familiar with the devices. One of the lecturers was from that area and he said they actually have color coded tags on each LVAD that gives the basics- proper settings for the patient flow rates, etc, type of device, and items particular to that model. The color coded tags correspond with a field guide provided to prehospital providers- nice.

[chbare]

Yep.

It's one of several places in the area that utilize the devices.

Apparently East Coast EMS is more familiar with the devices. One of the lecturers was from that area and he said they actually have color coded tags on each LVAD that gives the basics- proper settings for the patient flow rates, etc, type of device, and items particular to that model. The color coded tags correspond with a field guide provided to prehospital providers- nice.

They are catching on in the southwest as well. Phoenix is pumping them out with ever increasing numbers of destination therapy patients. The Heartmate II seems to be the device of choice. Many EMS considerations such as non pulsatile blood flow, CPR, electrical therapy, and even giving nitroglycerine.

[WolfmanHarris]

What a great topic! Wasn't familiar with this device (thanks to Spenac for the links) and after a quick read through I just fired off an e-mail to our Medical Direction for some more info and guidance.

[fireflymedic]

They are catching on in the southwest as well. Phoenix is pumping them out with ever increasing numbers of destination therapy patients. The Heartmate II seems to be the device of choice. Many EMS considerations such as non pulsatile blood flow, CPR, electrical therapy, and even giving nitroglycerine.

The Heartmate is also what tends to be the most common around here as most are on transplant lists. However, Jewish tends to take the mentality of if the patient is doing well and has a good quality of life and is happy, they may no longer recommend transplant. There are a few in the area that have had the devices for a while and are so pleased with their quality of life that they have chosen to remain on it. When I saw the difference in the size of what was formerly implanted and what is now, I was amazed. In addition to all the things the patients can do on it. Very much a normal life. I guess most suprising to me was that the doctor informed us that the vast majority can (and should) go by ground if possible as flight places additional stresses on the equipment unless the patient is an unreasonable distance away as most problems have already been discussed with the patient. We have a whole troubleshoot guide that we keep on file and also have the contact numbers as previously stated. I am curious though - has anyone experienced a patient that had a disection of one of the tubes? I am wondering if that is of concern for patients with airbags in crashes regardless of impact, I know some cars trigger airbags quickly. If so, let me know ! Thanks. Great topic again !

Yep.

It's one of several places in the area that utilize the devices.

Apparently East Coast EMS is more familiar with the devices. One of the lecturers was from that area and he said they actually have color coded tags on each LVAD that gives the basics- proper settings for the patient flow rates, etc, type of device, and items particular to that model. The color coded tags correspond with a field guide provided to prehospital providers- nice.

I've not seen those but I would definitely be interested in seeing them. Here we have to contact the people if patient is unable to tell us (though most of our patients are quite educated and teach us much better than anyone could !). If you have a link to a place which carries them, I'd like to see them. Thanks again.

[HERBIE1]

The Heartmate is also what tends to be the most common around here as most are on transplant lists. However, Jewish tends to take the mentality of if the patient is doing well and has a good quality of life and is happy, they may no longer recommend transplant. There are a few in the area that have had the devices for a while and are so pleased with their quality of life that they have chosen to remain on it. When I saw the difference in the size of what was formerly implanted and what is now, I was amazed. In addition to all the things the patients can do on it. Very much a normal life. I guess most suprising to me was that the doctor informed us that the vast majority can (and should) go by ground if possible as flight places additional stresses on the equipment unless the patient is an unreasonable distance away as most problems have already been discussed with the patient. We have a whole troubleshoot guide that we keep on file and also have the contact numbers as previously stated. I am curious though - has anyone experienced a patient that had a disection of one of the tubes? I am wondering if that is of concern for patients with airbags in crashes regardless of impact, I know some cars trigger airbags quickly. If so, let me know ! Thanks. Great topic again !

I've not seen those but I would definitely be interested in seeing them. Here we have to contact the people if patient is unable to tell us (though most of our patients are quite educated and teach us much better than anyone could !). If you have a link to a place which carries them, I'd like to see them. Thanks again.

The thing that was stressed to us in this symposium is that if at all possible, the patients need to be at a facility capable of dealing with this devices, although the coordinators give a heads up to whatever ER you arrive at. Depending on where you live, clearly that may mean a significant transport time.

Dennis Rivard of the Mid Atlantic Region Prehospital Task Force is the guy who discussed the color coded tags for his area. I did a quick search but could not find any contact info on the guy. Maybe you'll have better luck. Try to contact one of the vendors like HeartMate or Thoratec- they would probably be able to help.

[fireflymedic]

The thing that was stressed to us in this symposium is that if at all possible, the patients need to be at a facility capable of dealing with this devices, although the coordinators give a heads up to whatever ER you arrive at. Depending on where you live, clearly that may mean a significant transport time.

We were told unless it is one of the few major disasters (ie the pump has entirely quit working, disection of the tubes, etc) that transport time for a ground up to 4 hours tends to be the max that is acceptable through Jewish protocol. They are the local referral center, though there are two other facilities which may do the procedure, though by far they are the largest implanters immediately surrounding. Over 4 hours there is issues with the transportable battery (rather than the large one the patient uses as night). Also has anyone dealt with a BIVAD patient? We were given brief informatino on them a well. One other thing - were you trained on the handpumps for those that the LVAD entirely quit working or has significantly low output and have such terrible function on the right ? We were but just curious if anyone has had to use them yet.